HomeMy WebLinkAboutBLD-93-627 .Y . Oar FA,4
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; T `' TOWN OF YARMOUTH t F
MATTici
`� Wg ' Application11for a Permit to Build No._ CW
vlb AP q 3 LOT r� f 3
UPON FINAL APPROVAL ,,, kM
FEE MUSTACCOMPANYTHI tAPPLICATION. kDATE 6 f.4-a 19 9 3
The undersigned hereby app es for a permit to build +.,e., jy�f93
according to the following specifications
\ 1. Name of property owner Lew;S R. d Rut I. 1.4.A, in: no2 Tel. 30- -a-US
\ Address•" I I PoRtSmo..tti -lc 4itAt '/Altm0..4 s.
. , 2.Name of Architect(if any) / Tel.
\a Name of builder • Address %,
1
4. License No. Tel. 4,
5. Name of Mason — Address `N
6. License No. Tel. "•c
V. Construction address I I Poft 4S Mo-4 L 4(n. yA4wto- 1I pO1"-
Flood e- ZOnect g_te d
8. Date of subdivision Approval plain zone
9. Private dwelling 0 Estimated Cost - °q'- O NOT RITE IN THIS SPACE
P
} R�1� . -9 t — WVi7/9.5 Type of room (No.
10. Multi family ❑ 1 34 9-0 . — %. as-,t, • r
11. Commercial 0 Kitchen
12. Other ❑ e Dining Rm.
L�9•Q'�-,Th-- Living Rm.
13. No. of stories _ / 0 . bP, -Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 ! r&o Fan, at tit aecs
15. Materials — Wood 0 Cement 0 Other 0 /y X I i I _
16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 • Closed porch
Family Rm.
17. Garage — 1 ❑ 2 ❑ Sun room
18. Swimming pool - Size ' . • . Garage
19. Storage shed — Size Shed
20. Stove — Wood 0 Coal ❑ - Alterations -
21. Size of lot: No. of feet front No. of feet rear No.of feet deep
22. Size of building. No. of feet front No. of feet side No. of feet rear
2a Distance from nearest building: Front Ft. side Ft. side Rear
24. Distance back from line or street From rear lot line Side line
25. H.I.C.R. No.
LOT RELEASED BY Signature jaw (-- i
PLANNING BOARD ! Address I I l f►.:IS 1 0 •.th Trela kc.fz
Date -Tv I• i- d8" 043 \ Ahit Motrill 6-"CT AA 0-05
5//7/43
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: IE.-Lv/S /71/`/a2 BUILDING PERMIT I+:
'ADDRESS: J/ /t7 , O' 7 ' yj-9 TELE. NO. : DATE FILED:
BLDG. SITE LOCATION: .$',9-y�6L NAPA: 9 3 LOU: j�27
THE FOLLOWING INFORMATION OUTLINES THE PROCEDURAL STEPS REQUIRED TO OBTAIN A PERMIT TO BUILD,
ALTER, OR ADD TO A STRUCTURE WITHIN THE TOWN OF YARMOUTH. THE BUILDING DEPARTMENT WILL DETER-
MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD
PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH
THE FOLLOWING DEPARTMENTS:
RESIDENTIAL AND/OR COb21ERCIAL BUILDING
WATER DEPARTMENT: DETERMINES COMPLIANCE OF WATER AVAILABILITY.
ENGINEERING DEPARTMENT: DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE.
CONSERVATION COMMISSION: DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E.: IF LOT(S) BORDER ANY
TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH
LAND, ETC.
HEALTH DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E. : REQUIRE-
MENTS FOR SEPTAGE DISPOSAL AND OTHER PUBLIC HEALTH ACTIVITIES.
FIRE DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REQUIREMENTS FOR PERSONAL
SAFETY, PROPERTY PROTECTION, I.E. , SMOKE DETECTORS, SPRINKLER SYSTEMS,
ETC.
THE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR
ISSUING THE REQUIRED BUILDING PERMIT:
REV1E WATER
J
WATER DEPARTMENT t c•�, .:I '�• . �� n. .�rDATE: /i'-% , N/A:
21,....ENGINEERING DEPART NT: DATE: N/A:
5ONSERVATION: / Kir DATE: .. i 7 - ? 3- N/A:
UK-HEALTH DEPARTME DATE: g-/�q(c3 N/A:
INDUSTRIAL . o/OR Ct II'RCIAL PERMITS
5. WIRING INSPECTOR: DATE: N/A:
6. PLUMBING INSPECTOR: DATE: N/A:
7. FIRE DEPARTMENT: DATE: N/A:
PLEASE NOTE
ALL STUMPS AND/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE
DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING
PERMIT.
COMMENTS:/ i, .L _ - "I . r . ;�/ ..ma / y',. ..
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PLOT PLAN
• FOR LOT n ' 1 ` '
Indicate location cf garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) e
Well 0
•
.I (lot ( 1.3 ft. rear)
- - - - 1A'. 'rv`tLfiNbs - - -
4 .
kbuttor's I Abuttor'
Vame I Name
Lot if I Lot if
REAR YARD
:f this is a J If this
:orner lot, , ft. •
corner
write in name I write
)f sceet. I name •c
^ ether
c. ° s-re u
t
Crk1ter.
SID:" ? RE c .... SIDEYAR:' HOUSE
:-/ G FT. 0 q - -- - - -_0
b R FQ
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sE-Tr e I
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(i^` / fl f` fvntace) c
•
\ / f / lbCO's ?AbJT(f ( i*- 21 ?rc6
\ /
\ / (NAME OF STREET)
\ /
•
/ \ i:
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•
TOWN OF YAMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION -
PLEASE PRINT: q n
DATE C/;-6-
I > /1
JOB LOCATION I I Po(('f►ho.,} +tn. YAwtdwi
NUMBER STREET ADDRESS SECTION OF,TOWN
"HOMEOWNER" LtL;f i R.4 L m140 I. 7‘1,-2_1t9
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADRESS SA' &
CITY OR TOWN STATE ZIP CODE
•
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER-OCCUPIED
DWELLINGS OF SIX UNITS OR LESS AND TO ALLOW SUCH HOMEOWNERS TO ENGAGE AN IN- •
DIVIDUAL FOR HIRE WHO DOES NOT POSSESS A LICENSE, PROVIDED THAT THE OWNER
ACTS AS SUPERVISOR. (STATE BUILDING CODE SECTION 109.1.1)
DEFINITION OF 110MEOWNER: •
PERSON(S) WI10 OWNS A PARCEL OF LAND ON WHICH 11E/SHE RESIDES OR INTENDS TO RE-
SIDE, ON WHICH THERE IS, OR IS INTENDED TO BE A ONE TO SIX FAMILY DWELLING,
ATTACHED OR DETACHED STRUCTURES ACCESSORY TO SUCH USE AND/OR FAR."( STRUCTURES.
A PERSON WI10 CONSTRUCTS MORE TITAN ONE HOME IN A TWO-YEAR PERIOD SHALL NOT BE
CONSIDERED A HOMEOWNER. SUCH "HOMEOWNER" SHALL SUBMIT TO DIE BUILDING OFFICIAL,
ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT HE/SHE SHALL BE RESPONSIBLE
FOR ALL SUCH WORK PERFORMED UNDER THE BUILDING PERMIT. (SECTION 109.1.1)
DIE UNDERSIGNED "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE STATE
BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGULATIONS.
TBE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH
BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE
WILL COMPLY WITH SAID PROCEDURES AND REQUIREMENTS.
n '
HOMEOWNER'S SIGNATURE y` >fl 4-J
APPROVAL OF BUILDING OFFICIAL
NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED
TO COMPLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION CONTROL.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes ❑ No ❑
If you have checked,yes, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy 0 Other type of indemnity 0 Bond 0
OWNER'S INSURANCE WAIVER: I am aware that the licensee does net have the insurance coverage required by
Chapte 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
keck one:
Owner Agent 0
I Signa •re of Owner or er s Agent
•
• ` '== E COMMONWEALTH OF MASSACHUSETTS
P =
• -- DEPARTMENT OF IIIDUSTRIAL ACCIDENTS
600 WASHINGTON STREET
James Campoeu BOSTON, MASSACHUSETTS 02111 .
comm sstone WORKERS' COMPENSATION INSURANCE AFFIDAVIT •
•
I, 1,6w t i GL. Irk ( IV a-rs
(I i ce n s eelp erm i tte e)
• with a principal place of business/residence an
ii T v 'Pula n07- $E rt W- +ti ul. \ A 0 O V a ? alt`s' Kt , '47'
( try/Sure/Zp)
do hereby certify, under the pains and penalties of perjury,that:
[) I am an employer providing the following workers' compensation coverage for my employees working on this
job.
Insurance Company Policy Number
[ ) 1 am a sole proprietor and have no one working for me.
—/' am a sole proprietor, general contractor homeowner ( ' a one) and have hired the contractors listed below
Who have the following workers' compensation insurance policies: • - - .. ••-
Name of Contractor . Insurance Company/Policy Number . ..-... .
Name of Contractor Insurance Company/Policy Number
Nam.'
a of Contractor Insurance Company/Policy Number . -
I am a homeowner performing all the work myself.
NOTL.Please be aware that while homeowners who employ persons to do maintenance,construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally
considered to be employers under the Workers' Compensation Act(CL C. 152.sect. 1(5)).application by a homeowner for a license
or permit may evidence the legal status of an employer under the Workers'Compensation Act.
I understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' Office of Insurance for coverage
verification and that failure to secure coverage as required under Section 25A'of'v1GL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to 51500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 5100.00 a day against me.
Signed this Ll) m0/ t . day of %v-v , a.S" , 19 9f3
l�tt
•
Littr:se:/Permrte: Licensor/Permi :ar
•
Suggested Affidavit for Home Improvement Contractor Permit Application
For Office Use only NAMEOFCITY/TOWN
Permit No. a%�(y0$3.o•-_l fl
Date J
AFFIDAVIT
Home Improvement Contractor Law
• Supplement to Permit Application
MGL e.1411A requires that the"reconstruction.alteration.renovation.repair.modernization.conversion.inprovement.removal.demolition. .
or construction of an addition toanvpre-existing owner-rxcumed building cnntaimne at least one but not more thamfourdwelline units....or •
to structures which are adjacent to such residence or budding"be done by registered contractors,with certain exceptions,alongwitti other
requirements.
Type of Work: SGRee.. pu AC k Est. Cost f 6 0°- u tl
Address of Work II P04437...e-1\ 3tA.
Owner Name: LeL :5 (h:no t1
Date of Permit Application: 6'1k' q 7
I hereby certify that:
Registration is not required for the following reason(s): •
_Work excluded by law
Job under 51.000
Owilding not owner-occupied
wner pulling own permit
_Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
• CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL
C. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No.
OR:
Notwithstanding the above otice, I hereby apply for a permit as the owner of the above property:
1.4 15
tic 11--rwvvvri
Date Owner Name
•
• I N, • Application to •
v ,• 1 •
.„--:1 ,::.:0.1::::::„.1. Old King's Highway Regional Historic District Committee
°` •! ,A', in the Town of Yarmouth for a
, °
G "v~ i CERTIFICATE OF APPROPRIATENESS
Application is hereby made in triplicate.for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts. 1973,for proposed work as described below and on plans,drawings or photographs
accompanying this application for: -
\• CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construction: ❑New Building ❑Addition
'Alteration :-
Indicate type of building:VHouse 0 Garage 0 Commercial ❑Other E9
2. Exterior Painting: ❑
'93
3. Signs or Billboards:0 New sign 0 Existing sign 0 Repainting existing sign JUN 24 P 1 .35
4. Structure: 0 Fence 0 Wall 0 Flagpole 0 Other
n t;
(Please read other side for explanation and requirftwnsj.L DATEf �.„.. i 1 4
TYPE OR PRINT LEGIBLY
ADDRESS OF PROPOSED WORK A 'i f r lir S M p,. VA t v- r n c r ASSESSORS MAP NO.
OWNER I ec,} f S. fA . + R..+t- Lv 1,1 i v O ASSESSORS LOT NO.
HOME ADDRESS lI fDc* r.IS .w 0. Lt-4.,. Dery4 ' C.. tilt vr-,Ou '•)... TEL.NO. 3 ' a —a 9 a, •'
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
%1
•
fStC '0.4+a allA SHer ?- \ .- ;
\... Por ri0.vn-es d- a8 d re sc.{es) 9p PROVED
AGENT OR CONTRACTOR nr'
.f • v1:: b 13
TEL NO. ARNIQUMCOMMITTEE
ADDRESS OKHRD •
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No.8,other side),including
materials to be used. if specifications do not accompany plans. In the case of signs, give locations of existing signs and
proposed locations of new signs. (Attach additional sheet, if necessary). I. n cf o S t. CY* S F',r.c1 0 cct•C
w14•h• • Roos° ct„ ck Scr' eer, r4 SNAe5 (SLI_ Shin, fes and � rtw�,
pa-tn r " rna4ch eyt . 1- Irt.y House Gnd Qv ¢ `! e- _
Signed frt.,'
r1-777444„
Owner-Contractor-Agent
Space oeIow line for Committee use.
•
-Received by H.D.C. 11P P I;OW.: CONTINGENT *i?PS' ANY CrA.N1GDS FREQUIPE'D BY .'^:i:s BUILDING DEPT.
TO•MEI:T CODE Bit ,eF.PJP.TED MIN/tO :,T:IC.
Date •/ I53 —The-Certificate is hereby-. • -(Date _ �3 /�93
c`I •Time /,' / / iA i
e.
'0c ❑ IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal per:co
pro•nced in the Act.
-..-:revec ❑ Please return to: Yarmouth Histcnc Distnc: Commit:ea
• Town Hall. 1146 H!. 26. South Yarmouth. Mass. 02564
o
•
FULL NAME AND ADDRESSES OF ABUTTING OWNERS
Map 93, Lot M14 Ruth Crowell Black
7 Portsmouth terrace
Yarmouth MA 02675
Map 93, Lot M10 George C. Ricker
10 YarmouthmMAt002667srace 93 JUPJ 24 P 1 :35
Map94, Lot All William 0. Smith Jr. �'�`
16 Portsmouth Terrace IOWH �ltkY, IktA �jf!
Yarmouth MA 02675
Map 94, Lot Al2 Frances E. Wilson
17 Portsmouth Terrace
Yarmouth MA 02675
Map 94 Elisha's Pond
Ar PROVED
YARMOUTH COMM EIfT
OKHRD
r
310 CMR 10.99
' Farm 2
DEP File No.
.r' (To be provided by DEP)
Commonwealth city Town YARMOUTH
=='-ice_ : of Massachusetts
_== Applicant LEWIS R. MINOR
ralt •
Determination of Applicability '
•
Massachusetts Wetlands Protection Act, G.L. c. 131 , §40
and the Town of Yarmouth Wetland Bylaw
From Town of Yarmouth Conservation Commission Issuing Authority
To Lewis R. Minor Same
(Name of person making request) (Name of property owner)
Address 11 Portsmouth Terrace. Address Same •
YarmouthPort, MA
This determination is issued and delivered as follows:
C by hand delivery to person making request on (date)
x by certified mail, return receipt requested on August 6 . 1993 (date)
Pursuant to the authority of G.L. c. 131 , §40. the Town of Yarmouth Conservation Commission
has considered your request for a Determination of Applicability and its supporting documentation, and has
made the following determination (check whichever is applicable):
Location: Street Address 11 Portsmouth Terrara YarmniithPnrt . Mk
Lot Number: NI 13
1. G ' The area described below,which includes all/part of the area described in your request, is an
Area Subject to Protection Under the Act.Therefore, any removing, filling, dredging or
altering of that area requires the filing of a Notice of Intent.
2. E The work described below,which includes all/part of the work described in your request, is within
an Area Subject to Protection Under the Act and will remove, fill, dredge or alter that area.There-
fore,said work requires the filing of a Notice of Intent.
Effective 11/10/09
2-1
F.
/ 3. 0 The work described below, which includes all/part of the work described in your request, is within
the Buller Zone as defined in the regulations, and will alter an Area Subject to Protection Under
the Act. Therefore, said work requires the filing of a Notice of Intent.
•
•
. This Determination is negative:
1. 0 The area described in your request is not an Area Subject to Protection Under the Act.
2. 0 The work described in your request is within an Area Subject to Protection Under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
3. ac3c The work described in your request is within the Buffer Zone, as defined in the regulations, but will
not alter an Area Subject to Protection Under the Act. Therefore, said work does not require the
filing of a Notice of Intent.
4. 0 The area described in your request is Subject to Protection Under the Act, but since the work - •
described therein meets the requirements for the following exemption,as specified in the Act and
• the regulations, no Notice of Intent is required:
•
Issued by TOWN OF YARMOUTH Conservation Commission
Signature(s)
--ofze_,/ 7-: / 7 Z117/I (-- -e././(.4.7
it
97 ./�L
a, . .
• This Determination must be signed by a majority of the Conservation Commission. 4
a
On this /077 . day o��,../• �ii /-1 19 3 , before me .
personally aopeared �.^ t Un..rr. /1�.r_• , tome known to be the
person described in, and who executed, the foregoing instrument, and acknowledged that he:she executed
the sa a as his/her free act and deed.
K 711
2-rr rr i t ✓S�� 11 iL 71211 '�'11 tjl .--94871
Not rj Public My commission•exptres
This Determination does not relieve the applicant trom complying with all other applicable teoeral.state or local statutes,ordinances.
by-laws or regulations.This Determination snarl De valid for three years Corm tne date of Issuance
The applicant,the owner•any person aggrieved by this Determination.any owner of land abutting the land upon wnich the proposed work
is to De cone,or any ten residents of the city or town in which such land is locatec,are nereby notified of tnelr right to reouest ire Department
of Environmental Protection to issue a Suoerseoing Determination of AdderEDuny,providing tne request is mage Dy certified mail or nand
delivery to me Department,with toe appropriate filing tee and Fee Transmital Form as provided in 310 CMR 10.03(7)within ten days from
the date of issuance of this Determination.A copy of me request snail at the same time be sent by certified man or hand Delivery to me
Conservation Commission and the applicant.
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VII �51-✓ ax6 (t1gtl;re•s ; b ; n�.
I cf bZ PJM t6' b`ti�' APPROVED 1
. YARMOUTH COMMITTEE y k y P, :S
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`� _ •• w OKHRD i1k ,g ' : J. o;; S 1tI I6l. 0. C
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TOWN OF YARMOUTH
OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT COMMITTEE
3t tO
;4 SPECIFICATION SHEET
APPLICANT'S NAME Lt w .s + MM M ; nor FOR: c Arm u„
. FOUNDATION: •
. COLOR
SIDING: V_)OOa Sh 1v�rA� a5 '4'' 'm0.-V�h
fide COLOR:
•93 JUN V24 p1 :35
CEL"YEY. COLOR:
'CNN Ur '141,,NiaLLii
10WYN CLERK & I EASUf f is
ROOF MATERIAL: 4-O ,n-+ai•Gtr eX1Q' tnr PITCH: //y COLOR:
WINDOWS: No N SIZE:
TRL`! COLOR: ujh i
DOORS: 1 WOOS SC.reC-n COLOR:
SEU ERS: (A1\t�PRovo o COLD
x4Rh'OWN CO �
GUTTERS: 014D IIS COLOR:
DECK: SIZE: COLOR:
. GARAGE DOORS:. SIZ=: COLOR:
STORM WINDOWS & DOORS: COLOR:
SKYLIGHTS ..(FLAT ONLY) SIZE: COLOR:
ADDITIONAL INFORMATION: •
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